Drew G. Wallace, Inc.

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

License

6345 Issued in TX

Legal business name

DREW G. WALLACE, INC.

Doing business as

Angelo Chiropractic Center

Practice address

1801 W Avenue N
San Angelo, TX 76904-4628

Phone

(325) 949-7878

Fax

(325) 944-7703

NPI assigned

Oct 21, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Drew George Wallace, D.C.NPI 1205921608

Title

President

Phone

(325) 949-7878

Specialties & licenses 1

Addresses

Other names 1

• Angelo Chiropractic Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Drew George Wallace, D.C.

  • Chiropractor
  • San Angelo, TX
  • NPI 1205921608
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287619200000",
    "number": "1003126236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W AVENUE N",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769044628",
            "telephone_number": "325-949-7878",
            "fax_number": "325-944-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W AVENUE N",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769044628",
            "telephone_number": "325-949-7878",
            "fax_number": "325-944-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREW G. WALLACE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-21",
        "last_updated": "2010-10-21",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "DREW",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "325-949-7878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "TX",
            "license": "6345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angelo Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Cole Dougan, RPH
• Khristina Michelle Douglas, M.S., CCC-SLP
• Shannon Dowell
• Dr Sylvia Ana Soto, PC
• Dr. Alan C. Larsen, Optometrist, P.L.L.C.
• Freddie Eugene Drummond, PH.D.
• Luis E Duarte, MD
• Alicia Marie Dudley, LICSW
• Anna Dudney
• Douglas Allan Dunagan

• Neurology Chiropractor in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Neurology Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.